额部钻颅血肿引流术治疗高血压基底节区脑出血109例

目的 探索一种新的手术方法治疗高血压脑出血,既能避开重要功能区及重要血管分布区,又能达到与其他穿刺术式引流效果相仿. 方法 回顾性分析我科2010年8月至2011年10月行新术式穿刺的高血压脑出血患者109例,所有患者均经头颅CT确诊,根据多田公式计算出血量,分别采用局麻或全麻下额部钻颅软通道引流血肿78例,额部钻颅血肿引流配合脑室外引流20例,单纯行脑室外引流术11例. 结果 术后2～5d复查头颅CT示:血肿完全清除19例;血肿清除90％以上37例,血肿清除80％以上43例,清除50％以上8例,血肿清除小于50％2例;未发生切口及颅内感染;术后死亡6例. 结论 额部钻颅血肿引流术治疗高血压基底节区脑出血能有效避免对重要脑组织的损伤,减少手术并发症;血肿清除率高,提高了患者的生存率和生存质量.

The Treatment of Intracranial Hematoma Drainage by Drilling Cranium at the Frontal Region for Basal Ganglia Hemorrhage in 109 Cases

Objective To explore a new operative method for the treatment of hypertensive cerebral hemorrhage which can avoid the damage to the functional area and important vascular area while also can achieve the same therapeutic equivalence as traditional operations.Methods The clinical results were retrospectively analyzed in 109 cases of hypertensive cerebral hemorrhage underwent the new operative method in our department from August,2010 to October,2011.All the cases were confirmed by CT scam as the basal ganglia hemorrhage.Intracranial hematoma drainage by drilling cranium at the frontal region was done for all the cases. Results Two to five days after operation,the intracranial hematoma was completely disappeared in 19 patients,90% above cleared in 37 patients,80% above cleared in 43 patients,50% above cleared in 8 patients and less than 50% decreased in 2 patients.Neither intracranial infection nor wound infection was observed.Six patients died after the operation.Conclusion It can effectively avoid the damage to the important brain tissue,decrease complications of the surgery,and improve the survival rate and life quality of these patients via high hematoma clearance rate of the intracranial hematoma drainage by drilling cranium at the frontal region.